Pain and the Role of the Nurse in Helping Patients Manage Factors affecting it - Assignment Example

Pain and the Role of the Nurse in Helping Patients Manage Factors affecting it Introduction Pain is a crucial aspect of people’s lives and therefore the way it is managed is important in order that patients or people in general get to overcome its effects. The nurse also plays an essential part in this whole aspect of pain management. He/she is the person who has been mandated to take care of the patient’s well-being until they are fit enough to resume their day to day activities both physically and emotionally. It is mandatory that a good strategy is employed in managing the patient’s pain depending on the circumstances that caused the pain. The nurse should be involved in the whole process of finding a suitable solution to address the patient’s painful condition. This paper is going to address various aspects of pain. It will first give us a general and philosophical understanding of pain and explain both the behavioural and emotional factors that come into play in pain. It will then discuss how pain is perceived by people and the medical practitioners in general. This will be followed by a discussion of the various types of pain and a brief explanation of their causes. It will then move to the philosophical point where it will bring to light the various theories that have been put forward to explain pain. After having an understanding of these it will centre on explaining the role of the nurse in pain management. The paper will then look at one psychological approach and its use in managing emotional and behavioural factors associated with pain perception. It will conclude by reflecting on the information gathered and its importance to a medical practitioner in helping patients Pain, contributing factors and perception Pain is difficult phenomenon to define. This is because of it is a personal and subjective experience and no tow people will experience pain in exactly the same way. It has been defined in many ways. The International Association of Pain (IASP) defines it as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” (Farhadi & Esmailzadeh, 2011. Pp. 343). A second definition defines pain as “”whatever the experiencing person says it is, and existing whenever the person says it does.” (L.Oakes, 2011, pp. 3-4). Al these explain to us that acrually there is no standard definition of pain but it can be seen as something that makes a person uncomfortable and therefore necessitates the individual to seek medical attention because they are unable to stand the its effects. There exist behavioural and emotional factors that contribute to pain. The behavioural factors include any habit or action of an individual that contributes to the pain syndrome. The factors can be contorlled by the individual, they are modifiable and thus can respond to behaviour modification programs. These may include factors such as improper jaw opening, continuous application of pressure on body parts, gum chewing etc. on the other hand emotional factors are the psychological factors that contribute to pain and these include stress, depression and anxiety among others. These factors result in pain in many ways and it is important to deal with the root cause of each facotr if the pain is to be managed effectively (Turk, 2002, pp. 535-539). Pain perception refers to the different ways in which people or individuals view pain, its causes and its significance to them. The perceptions of pain vary with depending on peoples beliefs, cultures, attitudes, religion, and demographic factors among others. These factors pose a challenge to clinicians on the best way to approach and manage the effects of pain(IASP, 2002, pp. 1-9). Therefore pain perception is a broad concept that can only be understood by looking at various factors around the individual upbringing. The individual will seek attention or an intervention when they cannot withstand the pain. Other people may not seek help because of what the pain signifises to them. This is especially true in people holding strict religious and ethnic beliefs (Jackson, Meltzoff, & Decety, 2005, pp.772-74). Types of pain Broadly there are two types of pain that are commonly known: acute pain and chronic pain. Acute pain is pain that has a sudden onset and a foreseeable end. It is associated ofetn with traum or acute dieases such as a broken limb or for example, appendictis(Joaquin, 2008, pp. 1-5). Chronic pain is defined as that pain which has lasted for three or more months. It can also be understood as pain that has lasted longer than the time expected for normal healing (Joaquin, 2008, pp. 1-5). Chronic pain may be associated with one or more of the following: heart disease, hypertension, respiratory disease, diabetes, Gi disease, Arthritis, cancer, depression and pregnancy (Disorbio, Bruns, & Barolat, 2006, pp. 1-4). Various other categories of pain have been proposed and these are based on specific characteristics associated with such pain. These categories include: the area of the body involved, the dysfunctional system causing the pain, the period and pattern of accurence, the intensity and time since commencement and entiology (Tollison, Satterthwaite, & Tollison, 2002, pp.40-45). Theories of pain Many scholars have proposed a number of theories to explain, predict and summarize pain for easy comprehension. Two most common theories will be explained in this discussion to show the evolutionary process of pain theories. The first theory is the specificity theory that emerged in the 19th century and states refers to pain as a specific sensation that has its own sensory apparatus that are independent of touch and other senses. The sensory receptors as put forward in this theory respond to damage and send impulses along nerve fibres to target centers located in the brain. These centers then process the impulses to produce the experience of pain. This theory also proposes that the intensity of pain is directly related to the amout of associated tissue injury and therefore perceived that surgery was the only way to eliminate the root cause of the pain (Dannenbaum, 2010, p. 1). This theory has been discredited because of its ineffectiveness in addressing chronic pain. The second theory of pain is the gate theory that argues that there are multiple pathways in the human nervous system that are responsible for the control of pain. This theory has shown that pain does not necessarily occur at the place or site of the injury rather it is experienced in our nervous system and especially in the brain. This theory therefore brought about many approaches to pain management by srguing that the experience of pain is an interpaly of many factors that include physical,psychological and environmental. Thus effective intervetions are those that have both physical (eg. drugs, physical therapy) and psychosocial interventions for example psychotherapy, relaxation training etc (Dannenbaum, 2010, p. 1). Psychological factors affecting pain The are many pychological factors that affect pain. The gobal factors include personality, gender, age and culture. These factors were supported by early theories of pain and are seen as universal. The recent studies have identified specific psychological factors that affect pain and these include: fear, depressin, and coping(Anaesth, 2001, pp. 144-150). A look at some of th global for example personality show that people who are less hardy to hardships show less tolerance of pain stimuli and would complain more about pain. Gender studies on pain have also shown that women report more severe levels of pain, more frequent pain and pain of lonegr duartions than men. The specific psychological factors such as depression have also been studied and research shows that patients with chronic pain have been depressed to some degree but this may not be direct. When faced with pain people are forced to look for ways of responding to it by relieving or removing the stressor. Personality has an influence on how people respond to or cope with a stressful event (Anaesth, 2001, pp. 144-150). Role of the nurse practitioner in pain management The nurse plays a big role in pain management. The first role of a nurse is to assess the pain of the patient and this is done through proper communication techiques by empathizing with the patient and showing concern. A nurse will consuct initial assessment through diagnosis by asking relevant questions that will guide him/her in finding the best approach to take in managing the pain (MBN, 2010, pp. 4-6). The second role of the nurse is to prescribe pain medications that are appropriate for the diagnosed pain. There are various types of pain as identified above, some may require physical therapy while others may require psychological therapy. It is the role of the nurse to assess and prescribe the best intervention to help in addressing the pain. Drugs may be administered to help reduce the pain or other methods such as relaxation techniques can be used to relieve pain(Kaasalainen, et al., 2010, pp. 545-51). The third role of the nurse is to monitor the pain levels of the patient and the side effects that come as a result of pain medications. After administering physical therapy such as drugs, the patients pain may not be relieved immediately. Some chronic pain may remain persistent for a long period of time and therefore necessitating the establishment of mechanisms that can be used to monitor the pain levels and when a certain level is exceeded corrective measures can be taken. Drugs have side effects and these effects may bring other types of pain for the patient. It is the role of the nurse to monitor this and ensure that the side effects are mild and that they do not pose a threat to the recovery of the painful condition(Kaasalainen, et al., 2010, pp. 545-51). The fourth role is to consult and advocate for patients and staff needs. Patients with pain may require a high degree of attention and this may require the presense of a nurse all the time especially in older and younger patients. This may put pressure on staff and resources. It is the role of the nurse to ensure that the patient gets the required attention depending on their varied needs. The last role of the nurse is to lead and educate other staff members and patients about pain management. It is common to find people looking for medical attention to some painful conditions that are manageable by the individual. To help here a nurseshould be able to provide information to individuals both sick and health on how to manage different kinds of pain. He/she should also be in a position to educate other staff members on pain management so that a standardised approach is used to address pain (Kaasalainen, et al., 2010, pp. 545-51). Cognitive behaviour therapy approach Cognitive behaviour therapy is one psychological approach used in managing behavioural and emotional factors asociated with pain perception. This is a combination of treatments that are aimed at reducing or extinguishing the impact of those factors thatmaintain patients’ maladaptive behaviours, beliefs and their patterns of thought. This is usually organized as a progrmme of various activities and is delivered by a team of pain therapists that include anaesthetists, clinical psychologists and physiotherapists. This approach has seven key elements that shoud be followed for it to be successful and these include: direct and indirect positive reinforcement of pain behaviour, positive reinforcement of well behaviour, Physical fitness and function, cognitive reframing and critical process factors. It is important that these are followed to ensure positive outcomes (Anaesth, 2001, pp. 145-149). Conclusion In conclusion, the aspect of pain is seen to be complex and involving an interplay of many factors. Earliers theories try to explain it but non explains what it really is. The modern theories on the other hand capitalise on the shortcomings of the earlies theories to come up with a comprehensive theory that is used to explain pain and how to effecticely manage it. Many factors come into play when talking about pain both behavioural and psychological. All these factors have to be addressed with the correct approaches in order to effectively address pain. The nurse continues to play an important role in pain management from the onset of the pain, its diagnosis and in the prescription of the required interventions. They also play a big role in the monitoring and provision of information on how to cope with painful conditions. All these help us understand how to effectively manage pain and what approaches are effective in handling different kinds o painful conditions (Rich, 2000, p. 65-66). List of References Anaesth, J. (2001). The role of Psychology in Pain Management. British Journal of Anaesthesia, 87(1):144-152. Dannenbaum, S. E. (2010). The Evolving Theories of Pain Management. Retrieved November 27, 2011, from https://www.mhn.com/static/pdfs/Details_Evolving_Theory_Pain_Mgt.pdf Disorbio, J. M., Bruns, D., & Barolat, G. (2006, March). Assessment and Treatment of chronic pain: A physicians guide to a biopsychosocial approach. Retrieved November 27, 2011, from Practical pain management: http://www.healthpsych.com/articles/biopsychosocial_tx.pdf Farhadi, A., & Esmailzadeh, M. (2011). Effect of local cold on intensity of pain due to penicilin Benzathin intramuscular injection. International Journal of Medicine and Medical Sciences, 3(11):343-345. IASP. (2002). Culture and pain. IASP Pain clinical updates, Vol. X. No. 5. Jackson, P. L., Meltzoff, A. N., & Decety, J. (2005). How do we perceive the pain of others? a window into the neural process involved in empathy. Neuroimage, 24(2005): 771-779. Joaquin, S. (2008). Various types of pain explained. Retrieved November 27, 2011, from CVPPSG: http://cvppsg.org/library/varioustypesofpaindefined.pdf Kaasalainen, S., Martin-misener, R., N., C., A., D., Donald, F., & Baxter, P. (2010). The nurse practitioner role in pain management in long-term care. Journal of Advanced Nursing, 66(3), 542–551. L.Oakes, L. (2011). Compact Clinical Guide to Infant and Child Pain Management: An Evidence-Based Approach for Nurses. New York: Springer Publishing Company. MBN. (2010). Pain Management Nursing Role /Core Copetency: A guide for nurses. Retrieved November 27, 2011, from Maryland Board of Nursing: http://www.mbon.org/practice/pain_management.pdf Rich, B. A. (2000). An Ethical Analysis of the Barriers to Effective Pain Management. Cambridge Quarterly of Healthcare Ethics, 9: 54-70. Tollison, C. D., Satterthwaite, J. R., & Tollison, J. W. (2002). Practical pain management. Philadelphia, PA: Lippincott Williams & Wilkins. Turk, D. C. (2002). Psychological approaches to pain management: a practitioners handbook. (D. C. Turk, & R. J. Gatchel, Eds.) New York: Guilford Press. Read More